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<br /> <br /> <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Walker Mng & Milling <br />M-79-181 <br />Ruby Trust Mj.ne <br />09/01(87 <br /> <br /> <br />110 Enclosure <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />~.,.., Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />y,,.X Annual Report <br />Remarks: <br />44~~LICER <br />~ MILLING, <br />Signature <br />(Rev. 02/87) <br />5257E <br />